Individual
TEJUN LEIGH BOGACZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-A
Contact information
Practice address
18332 W CINNABAR AVE, WADDELL, AZ 85355-4352
(602) 397-4334
Mailing address
18332 W CINNABAR AVE, WADDELL, AZ 85355-4352
(602) 397-4334
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA13283
AZ
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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